Dying Changes Everything
. Dying Changes Everything is the first episode of the 5th season of House which first aired on September 16, 2008. The team treats the assistant of a powerful woman and Thirteen starts to see something of her own nature in the patient’s subordination to her employer. In grief over Amber's death, Wilson contemplates resigning from the hospital. When House reacts by telling him to get over it, their friendship is strained to the point where Cuddy has to be called in to do the equivalent of couples counselling. However, when push comes to shove, it appears that House may have to choose between his friendship with Wilson, the life of his patient, or his job at Princeton-Plainsboro. The fifth season premiere used the natural break between seasons to naturally build the tension over the ramifications of Amber's death. When we return to PPTH, just as much fictional time as real time has passed, and Wilson is still at an impasse. Like House, we've been anticipating what would happen after House and Wilson parted without a word. Certainly, this is not the only episode where Hilson, the eternal bromance, has been threatened. However, it is one of the ones that posed the greatest challenge to the relationship between the two men. Cuddy, probably far too late, tries to mediate between the two, but her motives are far from clear - and Wilson knows it. Ostensibly, she wants to keep Wilson at the hospital. However, her hidden agenda is that she knows that it's unlikely that she will be able to handle House without Wilson's help. Throughout the series, it's usually been Wilson suggesting ways to Cuddy to keep the brakes on House's more excessive behaviors, and neither of them have been above using House's relationship with Wilson to manipulate the hospital's resident mad genius. Meanwhile, the character that gets developed the most is Thirteen as her reaction to her Huntington's diagnosis finally gives us more insight into her personality. Like many of the others on the team, we find out that she wants to work for House so she can become her own version of House - a person who makes a difference in the world. Her disclosure of the diagnosis to the patient mirrors House's own disclosure to the patient in Pilot and shows that House and Thirteen have something in common - they both feel vulnerable when reaching out to other people and draw much of their strength by keeping their pain, fear and feelings bottled in. Recap A boss and her assistant arrive at a meeting. The boss starts speaking to a meeting about the audience's lack of women in the executive office. Suddenly, her assistant starts screaming that she's covered in ants. Meanwhile, House is enjoying a video game (Ninja Gaiden II) in the coma ward. Cuddy comes in to say Wilson has returned after two months away. She pulls out his video game. House says he hasn't spoken to Wilson since Amber died. Foreman comes in with a new case - the assistant ripped off her clothes during the meeting. House thinks its a mental illness, but Foreman tells him she has real physical symptoms. House is interested, but Cuddy wants to give the case to someone else, so he can deal with Wilson. House takes the case anyway. House starts a differential with the team. They wonder why he isn't speaking to Wilson. They note the assistant travels a lot, so it might be malnutrition. When Thirteen suggests an insulinoma, House discloses that she probably has Huntington's. He sides with Taub that the patient has B-12 deficiency. Thirteen denies to the team that she has Huntington's. She then goes to see the patient to tell her about the B-12 deficiency, then tells her to get back in bed because she needs rest. Suddenly, the patient feels a sudden urge to go to the washroom, but Thirteen finds that she's bleeding. House goes to see Wilson to talk about Thirteen. Wilson tells House he's resigning. House tells him that his reaction is typical of bereavement. When Thirteen comes in to talk to House about the rectal bleeding, House sends her away. Wilson rejects House's advice and goes to wrap up his practice. Taub is not as concerned about House's indifference with the case as Thirteen is and concentrates on why she is bleeding. However, he can't find a bleed anywhere in her digestive tract. However, Kutner finds that one of her routine tests shows she is pregnant, which explains her symptoms. However, when they do the ultrasound, they can't find a fetus. They inform House of the inconsistency - positive pregnancy test and no pregnancy. Foreman wonders why House isn't more interested. House finally starts a differential. He tells them to keep going while he sees Wilson. He once again confronts him about leaving, but Wilson thinks House is being insensitive. The team comes in and finds out Wilson is leaving. House ignores his team and tells them that the patient must be pregnant. House goes to do the ultrasound again himself. He finds the patient is 37, and then he finds the fetus has dropped too far - it's taking blood from her intestines to cause the bleed and the neurological symptoms. He tells them to remove the fetus. Thirteen confronts him in the hall about trying to save the fetus, but he reminds her it's too dangerous. He then reminds her she can't let her Huntington's color her every diagnosis - people die. Thirteen goes to see the patient, who readily agrees to the abortion. House goes to see Cameron about Wilson. She reminds him how grief is unique to everyone. He tells her that everyone suffers grief, but you have to get over it. Cameron tells House that when her husband died, she too moved and got a new job. Chase operates to remove the fetus. The patient starts bleeding. Chase orders them to squeeze the spleen to start platelets flowing, and the crisis ends. He successfully removes the fetus. House tells Cuddy that she has to get Wilson to stay. Cuddy tells House he can't just be dismissive of Wilson's feelings. She tells him to apologize, but he doesn't feel he has anything to apologize for. Cuddy agrees, but asks him if he has any guilt at all. She tells him if he wants to keep Wilson, he has to find a way to do it himself. The patient is not recovering well from surgery - she keeps blinking and her heart slows dangerously. The team realizes that the pregnancy may have been just a coincidence. House goes to see Wilson again, threatening to stay home until he agrees to stay. House gets a page that the patient is in cardiac arrest, but he leaves the pager with Wilson says he’s going home until Wilson agrees to stay. House's team wonders where he is. They fit the patient with a pacing wire. Cuddy takes over the case and tells the team that she has confidence in them. Thirteen thinks they can do it themselves and suggests multiple sclerosis. Foreman orders interferon. Cuddy goes to see House. He says he told Wilson he was sorry, but Wilson didn't believe it, probably because House didn't mean it. He tells Cuddy to fire him if she doesn't like the fact he left the patient. When Cuddy confronts him, he slams the door in her face. She tells House that he's running away too, just like Wilson. The patient admits to Thirteen that her boss would get along just fine without her. Suddenly the patient starts shivering and has a fever. That means it can't be multiple sclerosis. Cuddy has House's cable cut off so House goes to confront her. She's cut off his TV entirely. Wilson arrives and Cuddy threatens him with not telling anyone else what his salary is, making a job search impossible. She welcomes them to couples counselling. The team is arguing while watching the surgery video, but Kutner spots something. He thinks it might be a ganglioma, a broken bundle of nerves. Foreman realizes that could explain her symptoms and they have to do a biopsy. Cuddy tells Wilson and House to talk it out, but they both refuse. When Cuddy confronts Wilson, he walks out, reminding them that no-one but him even liked Amber. Chase doesn't want to do a second major surgery because he doesn't think she has a ganglioma and she won't survive the general anesthetic. Thirteen says Chase would do it for House. He agrees he would, but still won't do it. Kutner comes up with another idea - coming in through the intestine - painful but no surgery risk. The patient wants to speak to House and reveals that she's been fired. However, she doesn't seem to care about being fired and Thirteen wonders why she agrees to be treated like a doormat. The patient says that's its better to be close to the birds than to wish you had wings. They perform the procedure on the patient and find the suspected site for the biopsy. Foreman cuts off a piece. Cameron finds Wilson to tell him he shouldn't go. She says she first refused to talk to him when House asked, but also agrees that House is right. She tells him the pain doesn't go away, but making a big change doesn't help either. She keeps thinking of her husband all the time. She tells him to do something, but not to leave. The biopsy shows it might be amyloidosis. However, they still have to find the cause. Foreman asks Wilson to call House. Wilson thinks it's impossible to rule out lymphoma. Foreman agrees to start chemotherapy. He then tells Wilson he thinks he should leave if he wants to because everyone else is just afraid to lose him and don't care what he wants. The patient starts to feel better on chemotherapy. Thirteen apologizes for getting angry with the patient. The patient thinks Thirteen might actually have her own wings, but Thirteen reveals that she has Huntington's and will start to deteriorate soon. The patient realizes Thirteen wants to make a difference. The patient tells Thirteen that she's applied for a new job. House finds a remote in the clinic. Cuddy wants to know why House is afraid of losing Wilson, but he ignores her. He thinks of something - the patient looks much older now, more like her age. He realizes her bruises are lesions - she has leprosy. The chemotherapy is killing some of the bacteria, but it will also wipe out her immune system. This type of leprosy makes her skin look younger, which is why she didn't look her age. The stress of the pregnancy caused the leprosy to be more active and explained the other symptoms. The patient reveals her boss is hiring her back because her replacement couldn't handle it. House tells Thirteen not to feel so bad about being wrong about lymphoma - at least she had a good theory and stuck to her convictions. She’s upset that the near death experience didn’t make the patient leave her boss. He reminds her that dying changes everything, but almost dying doesn't. House goes to apologize to Wilson and admits Amber is dead because of him. However, Wilson doesn't blame House for the death - he then admits that he's not leaving because of Amber. He's leaving because of House's manipulation and he's been enabling his behavior. He wishes House had been alone on the bus, and he learned from Amber he has to take care of himself. He didn't tell House before because he didn't want to hurt him, like he never wants to hurt him. He leaves saying they are no longer friends, and maybe they never were friends. Major Events * Two months have passed since Amber Volakis died. * Cuddy tries to get House and Wilson to talk to each other again but her attempts fail. * House tells the rest of the team that Thirteen tested positive for Huntington's * Thirteen tries to cope with her Huntington's diagnosis. * Wilson officially resigns from his job at the hospital and ends his friendship with House. Title The title could be a play on other common idioms, such as “Money Changes Everything” or “This Changes Everything”. Zebra Factor 9/10 Leprosy is rare even in people with an extensive history of worldwide travel. Most people are naturally immune to it. Trivia & Cultural References *The videogame House is playing on the X-Box is Ninja Gaiden II *The Salvation Army is a Protestant religious denomination and charitable organization founded in 1865. *More about Pewaukee, Wisconsin. *A Tanto is a short-bladed Japanese samurai sword. *"Miss Steinem" is a reference to feminist Gloria Steinem *Newark is the largest city in New Jersey and lies across the Hudson River from Manhattan, New York. It is the home of Newark International Airport, one of the three major airports serving New York City. *Another reference to a “pine box” as a euphemism for a casket. *Training wheels are a pair of small wheels attached to the rear wheel of a bicycle that holds the bicycle up while it is stationary. They are used for new cyclists to keep them from falling over when their speed drops too low. As in this episode, they are often used as a metaphor for someone who works with a lot of guidance. *The episode ran one minute longer than it's scheduled time slot. As a result, many people who recorded the episode missed the last scene. Reviews The episode received generally positive reviews - a great accomplishment given the quality of the season four finale. The greatest praise was saved for Robert Sean Leonard who was finally allowed to fully exercise his acting abilities by fully and accurately expressing Wilson's grief over Amber's death without ever becoming melodramatic. * TV.com users rated the episode an 8.7. They voted Hugh Laurie as the most valuable performer. * IMDB users rated the episode an 8.5. It did best with females under the age of 18 (9.0) and worst with the top 1000 voters on the site (7.5) * The Onion AV Club gave the episode a B+, praising Robert Sean Leonard's depiction of grief over Amber. * Polite Dissent rated it an average episode with a B for the medical mystery and the final solution, but a C- for the medicine. It gave the soap opera plot a B+ Medical Ethics Responsibilities of an attending physician On the show, the medically responsible physician for an individual patient is referred to as an "attending". The actual term for such a physician changes from place to place, but their responsibilities are pretty much the same no matter what hospital you're in: * Approve all treatment and testing plans for the patient * Be available for junior staff (usually a resident, but possibly a fellow), either in person, by phone, or by pager * Delegate tasks the attending is not capable of performing themselves to other qualified physicians Whether or not the attending actually does these things is irrelevant in determining whether they are responsible for the patient's care and the actions of the junior staff - the attending is deemed to be responsible even if they abandon the case (without finding a new attending), they don't see the patient, or they fail to respond to their junior staff. Obviously, in this episode, Cuddy should have found the patient a new attending physician while House dealt with Wilson. Attending physicians usually report directly to department heads (who don't often act as attendings themselves because they often have to deal with administrative and educational tasks) but since House is also technically a department head, he answers directly to Cuddy. Residents and fellows generally don't have a duty to report to the department head if the attending isn't following through. As such, responsibility for House's actions falls directly on Cuddy once she knows he isn't doing his job. House's team is clearly not following proper protocol by ordering tests (particularly invasive procedures) and approving treatment without getting his approval first. Cuddy does have a lot of faith in House's team, and deservedly so, but she would still have to discipline House if his team screwed up in this situation (see, for example, The Mistake, where House is suspended for Chase's mistake). Medically necessary abortion Ectopic pregnancies are extremely dangerous. They are the leading cause of death in the first trimester of pregnancy worldwide, and are almost always fatal in the absence of treatment. Death usually occurs when the fetus outgrows the space it occupies and caused uncontrolled bleeding. Fetal survival in an ectopic pregnancy is not unheard of, but is very rare, and only happens when the fetus is allowed to come to full term. Even then, delivery of the newborn must be performed surgically. As such, ectopic pregnancy is clearly a condition where abortion is medically necessary.. If the condition is found early enough, methotrexate can be administered to chemically abort the fetus. Otherwise, the fetus has to be removed surgically. House, unlike usual on ethical questions, is totally right here. It's difficult to understand Thirteen's position (which House totally, if inelegantly, demolishes in rebuttal), although the issue of attempting to save what appears to be a non-viable pregnancy was explored in Fetal Position. Luckily, the law appears to be clear - removing an ectopic pregnancy is not defined in any way as an "abortion". However, that doesn't seem to have stopped a small number of anti-abortion activists from trying to tie the two together. The American Right-to-Life Association (an anti-abortion group) has tried to point to successful full-term ectopic pregnancies. Although they don't oppose removal of ectopic pregnancies (as long as the physician takes no overt action to damage the fetus after removal) they have tried to oppose other forms of medically necessary abortions which are often referred to as "late-term", even though that term isn't a medical term of art. The chill on such procedures makes doctors reluctant to undertake them. They also oppose abortions in rape cases (see One Day, One Room) and incest cases (luckily not a possibility in Skin Deep). Although Roe v. Wade ''is now well over 40 years old, its rationale is still deeply misunderstood. The law in question in ''Roe ''did allow abortions to save the life of the mother, but the majority felt the constitution required more to avoid trying to second-guess the decisions of physicians. One of the physician intervenors in the case made the point that it was difficult to determine, under the statute, which abortions were medically necessary. The court agreed:. "This means, on the other hand, that, for the period of pregnancy prior to this "compelling" point end of the first trimester, the attending physician, in consultation with his patient, is free to determine, without regulation by the State, that, in his medical judgment, the patient's pregnancy should be terminated. If that decision is reached, the judgment may be effectuated by an abortion free of interference by the State.". Goofs * Seriously, the team missed an ectopic pregnancy? A first year medical student might miss that, but not a board certififed physician. The positive pregnancy test combined with abdominal pain and unexplained bleeding practically defines that diagnosis * Although it was probably correct that a patient in Lou's condition could not survive the general anesthesia required for surgery, she most likely would have been able to tolerate other pain management such as intravenous sedation, local anesthesia, or even painkillers during the hunt for the ganglioma * There are several different types of lymphoma and each requires a targeted approach with a different chemotherapy agent. A doctor would not just start a lymphoma patient on chemotherapy without confirming what type it was. * Primary amyloidosis (which is the type generally seen on the show) cannot be distinguished from secondary amyloidosis without further testing. * B-12 deficiency cannot be cured with a single shot of the vitamin. In most forms of the deficiency, the patient may require a lifetime of ongoing injections, changes in diet, or a regimen of supplements. * The blinking green light on the X-Box controller House is using shows that the controller is either not physically connected to the X-Box, or is not properly connected. Either way, he couldn't be playing a game while the controller was in that state. * The man in the coma constantly moves his hand as House uses it for a cup holder. * The team initially rules out an infection because of the lack of fever, but doesn't put it back into the differential once she develops a fever. * During the scene where House aplogizes to Wilson, the reflection on the television frame in the background changes position, showing the source of the lighting or the position of the television has been changed. * In the scene where Lou is sitting in the chemotherapy chair, her ankles are crossed when shot from one angle, but uncrossed when shot from other angles. * The team only notices bruises just before making the final diagnosis, but they must have existed from the beginning and the team didn't mention them. * A reverse goof, something that isn't a goof in this episode but is done wrong in almost every other episode - the surgical team is all wearing eye protection. Quotes 'Dr. Lisa Cuddy: '''You are not listening to me, are you? Dr. Gregory House: Try it sometime - you'll see why.'' ''Dr. Lisa Cuddy: House opens his door Mind if I come in?'' ''Dr. Gregory House: Not at all. Mind if I leave?'' ''Lou: Hey, who are you?'' ''Thirteen: This is Dr. House. He's too brilliant for introductions.'' ''Dr. James Wilson: I need a change of scenery.'' ''Dr. Gregory House: Buy a plant!'' ''Dr. Gregory House: So you're treating professional sports injuries now?'' ''Patient: Oh, no, I'm not...'' ''Dr. Gregory House: ...familiar with the concept of sarcasm. Don't sweat it, it's new.'' ''Dr. Gregory House: I like you better now that you're dying.'' ''Thirteen: I was wrong.'' ''Dr. Gregory House: You took a shot.'' ''Thirteen: She's going back to work for that idiot. It's pathetic.'' ''Dr. Gregory House: You thought something would change?'' ''Thirteen: She almost died. Because of that job. Yeah, I... I thought...'' ''Dr. Gregory House: Almost dying changes nothing. Dying changes everything.'' ''Dr. Allison Cameron: Wilson You want me to sleep with him to get him to stay?'' ''Dr. Gregory House: I put the bisexual chick on that. If you'd like to sit in, so to speak...'' ''Thirteen: Then what do you suggest? Because the patient's got a high fever, a low heart rate and a dim chance of survival if we stand here like idiots.'' ''Dr. Robert Chase: Then I suggest you don't stand there like idiots.'' ''Dr. Eric Foreman: We just got a call from Patty Mitchener from Women's Majority, the women's rights...'' ''Dr. Lisa Cuddy: We know who she is.'' ''Dr. Gregory House: I dated her. Well not really dated her - more metaphorically raped her by having a penis. Foreman You did, too.'' ''Dr. Chris Taub: She's bleeding from... nowhere.'' ''Dr. Lisa Cuddy: Talk to each other.'' ''Dr. Gregory House: How are you doing? Good?'' ''Dr. James Wilson: Fine, thanks. both get up to leave'' ''Dr. Lisa Cuddy: Eh, eh, eh, eh, sit! both sit back See? The two of you are friends. Look how you both...'' ''Dr. Gregory House: ...think you're an idiot. We both also eat with forks. That doesn't really prove...'' ''Dr. Lisa Cuddy: Talk to him! Tell him how you feel about what he's doing.'' ''Dr. Gregory House: I told him he's an idiot.'' ''Dr. Lisa Cuddy: Tell him what you think about him leaving.'' ''Dr. Gregory House: I think he's an idiot.'' ''Dr. Lisa Cuddy: You're an idiot. He's in pain, and your response is just to emotionally blackmail him!'' ''Dr. Gregory House: You told me what's your position on this one. You're against it, right?'' ''Dr. James Wilson: She hasn't told you in front of me. She needs to prove she's on my side.'' ''Dr. Lisa Cuddy: Wilson Go to hell!'' ''Dr. Gregory House: So much for that theory.'' ''Dr. Robert Chase: You want me to do a *second* major surgery, on a patient we almost lost during a *first* major surgery, to see if she needs a *third* major surgery?'' ''Dr. Lisa Cuddy: Why do you think Wilson's leaving?'' ''Dr. Gregory House: How many times do I have to use the word "idiot"?'' ''Thirteen: Why is everyone leaping to conclude a strong career woman's been made sick by her strong career? It's not B12! It's an Insulinoma in her pancreas... it's making her hypoglycemic.'' ''Dr. Gregory House: sarcastically Oh, great! Now everyone knows!'' ''Dr. Chris Taub: You knew she had cancer?'' ''Dr. Gregory House: Is that what she said? I thought she said: "I am suddenly and irrationally defending the patient's strong career, even though in reality she's just a glorified grunt, because I am trying to convince myself that it's okay not to have a life, because I don't have a life, because I was tested for Huntington's and my lifespan's been cut in half." Been waiting for two months for her to say that.'' ''Dr. Gregory House: I'm busy.'' ''Thirteen: We need you to...'' ''Dr. Gregory House: Actually, as you can see, I'm not busy. It's just an euphemism for "get the hell out of here!"'' ''Overweight Patient: The two of you used to be together?'' ''Dr. Gregory House: She dumped me when I lost the last 85 pounds. Said it was less of me to love.'' ''Dr. Gregory House: Patient's in cardiac arrest. Ouchy!'' ''Dr. Chris Taub: Who wants to go service House, so this patient can live?'' ''Dr. Lisa Cuddy: When was the last time you talked to him?'' ''Dr. Gregory House: I think it was after... when did his girlfriend die? He wanted time alone. Considered being a horrendous pain in the ass but I didn't want to step on your turf.'' ''Dr. Lisa Cuddy: Tell him you're sorry.'' ''Dr. Gregory House: I didn't kill her!'' ''Dr. Lisa Cuddy: You were drunk and...'' ''Dr. Gregory House: ...yeah! If her daddy hadn't been drunk she might've never been born so...'' ''Dr. Lisa Cuddy: You called her up in the middle of the night. She was on the bus because of you.'' ''Dr. Gregory House: I didn't ask her to come out. I wasn't driving the bus. I wasn't driving the garbage truck that hit the bus. And I did not prescribe her the flu meds that killed her.'' ''Dr. Lisa Cuddy: Yes, I know. That's all true but... you really don't feel any sense of guilt?'' ''Wilson: I'm leaving'' ''House: What? Are you going to take another two months. Boy, you're really milking this bereavement thing, aren't you? I mean good for you. Take all the time you need.'' ''Wilson: I'm resigning. Maybe moving out of New Jersey. I don't know yet.'' ''House: Okay. That's an understandable reaction.'' ''Wilson: It's not a reaction. It's a decision. I'm writing Cuddy my resignation right now. I'm just back for a week to wrap up my clinical and administrative duties.'' ''House: You of all people should know, this is bereavement 101. You think that a chance in venue—'' ''Wilson: Well, that spares me decades of psychoanalysis.'' ''House: I'm not saying you're not in pain.'' ''Wilson: You're saying my pain's a cliche.'' ''House: I'm saying that pain fades.'' ''Wilson: Did yours?'' ''House: Physical pain is different.'' ''Wilson: I'd rather have my leg chopped off.'' ''House: You don't know that 'cause you haven't felt—'' ''Wilson: Neither have you.'' ''House: This is your grief talking. And yeah, it is a little textbook. So, before you give away all your possessions to the Salvation Army—'' ''Wilson: My girlfriend's dead. I'm glad you've read that book before. I haven't.'' ''House: You have to stop Wilson from committing career malpractice.'' ''Cuddy: Talk to him.'' ''House: I already talked to him. Twice.'' ''Cuddy: Mocking him and insulting him --- let's see --- yes, technically those are categories of conversation.... Talk to him. Deal with his grief. Talk to him about what he's going through.'' ''House: That's a brilliant idea. I'll take him out for a beer. That'll make up for the fact that Amber's in a pine box and that there's randomness and chaos in the universe.'' ''Cameron: So, your last day's Friday.'' ''Wilson: I'm going to miss you.'' ''Cameron: You shouldn't go.'' ''Wilson: Did House ask you to talk to me or are you trying to save the patient? Because there will always be—'' ''Cameron: House asked me.'' ''Wilson: And you're doing it—'' ''Cameron: I told him to go to hell.'' ''Wilson: Thanks.'' ''Cameron: But I think he's right. You think you're making a rational choice. You think the worse is over. And then six months later you look back and you realize you didn't know what you were doing.'' ''Wilson: Are you saying the pain doesn't go away?'' ''Cameron: It gets easier. Not in two months. Not in two years. But no. It never really goes away.'' ''Wilson: Being here— This building— I was just in the lounge. I kept staring at Amber's locker.'' ''Cameron: I saw a guy wearing a scarf this morning. The color reminded me of his eyes. We lived 500 miles from here.'' ''Wilson: I have to do something.'' ''Cameron: Then do it. But don't think it's the right choice. Because there isn't one.'' ''Wilson: This isn't just a pretext to pressure me into staying?'' ''Foreman: Does it look like a pretext?'' ''Wilson: No. She really is dying, isn't she?'' ''Wilson: ...It could be Lymphoma.... I'm an oncologist. I see cancer.'' ''Foreman: You should leave. House doesn't want to lose his sidekick. Cuddy doesn't want to lose her check on House. No one's talking about what you want.'' ''Wilson: It's not that I want to.'' ''Foreman: Want to. Need to. If there's any chance that being away from here will make your life even a little bit easier. Do it. It's what everyone else here would do.'' ''Thirteen: I have Huntington's Chorea. A dozen years or so my nervous system, my cognitive skills, even my emotional balance. They'll all start to fray.... I won't be able to walk. I won't be able to breathe.'' ''Lou: And you want to make sure your life matters.'' ''Thirteen: I don't want to just be tightening blots and following instructions. I want something to be different because of me.'' ''House: I'm sorry. I know I didn't try to kill her. I know I didn't want to hurt. I know it was a freak accident. But I feel like crap and she's dead because of me.'' ''Wilson: I don't blame you. I wanted to. I tried to. I must have reviewed Amber's case file a hundred times to find a way— but it wasn't your fault.'' ''House: Then we're okay? I mean I know you aren't but— Maybe I can help.'' ''Wilson: We're not okay. Amber was never the reason I was leaving. I didn't want to tell you because— because I was trying like I always do to protect you, which is the problem. You spread misery because you can't feel anything else. You manipulate people because you can't handle any kind of real relationship. And I've enabled it. For years. The games. The binges. The middle-of-the-night phone calls. I should have been the one on the bus not...you should have been alone on the bus. If I've learned anything from Amber it's that I have to take care of myself. We're not friends any more, House. I'm not sure we ever were.'' ''Thirteen: Damn.'' ''Lou: What?'' ''Taub: She's happy you're going to be fine... but she'd be happier if you were going to be fine five minutes ago.'' ''House: Either she cracked under the whip or she started to realize that her evolutionary purpose is to arouse men, not to castrate them.'' ''Taub: What do you want us to do?'' ''Dr. Cuddy: The same thing you do if he was here.'' ''Taub: If he was here we'd be asking him what to do.'' ''House: People get what they get. It has nothing to do with what they deserve.'' ''Dr. Cuddy: House has more important things to do.'' ''House: Sorry, can't help you. You need a specialist to remove those kind of warts. Preferably someone with experience spelunking.'' ''House: You're being an idiot. You're gonna blow up your career, and six months from now, when you've moved on from Amber--to Burnt Sienna--you're gonna be stuck in a mobile oncology truck in Pewaukee, Wisconsin.'' ''Dr. Wilson: I'd need a flowchart to explain all the ways in which that was ridiculously insensitive.'' ''House: Grief is Newark. Okay, it's there. You can't avoid it. The idea is to hold your nose, hope the traffic's not too bad, and get on to Manhattan as quickly as possible, not to buy property.'' ''House: If I told you that I was sorry, would it change anything?'' ''Dr. Wilson: I wouldn't believe you.'' ''House: If you believed me.'' ''Dr. Wilson: It's hard to imagine such a world.'' ''Dr. Wilson: I've got to do what's right for me. You got to do what's right for you.'' ''House: Yeah, but it comes easier for me.'' ''Dr. Foreman: But we're not talking about another videotape. This one showed a bump. We need to biopsy.'' ''Dr. Chase: A bump? Oh yeah. My grandfather died of a bump.'' ''Kutner: How do you get coal out of a mountain when it's someone else's mountain? If we don't have House, it doesn't mean we can't think like House.'' ''Thirteen: But it does mean we don't have to talk like him.'' ''Thirteen: We can have anything.'' ''Lou: No we can't. We can aspire to anything, but we don't get it just because we want it. I would rather spend my time close to the birds than waste it wishing I had wings.'' Cast *Hugh Laurie as Gregory House *Lisa Edelstein as Lisa Cuddy *Omar Epps as Eric Foreman *Robert Sean Leonard as James Wilson *Jennifer Morrison as Allison Cameron *Jesse Spencer as Robert Chase *Peter Jacobson as Chris Taub *Kal Penn as Lawrence Kutner *Olivia Wilde as Remy Hadley *Christine Woods as Lou *Jamie Rose as Patty Michener *Bob Sherer as Patient *Janet Song as Surgeon *David Kagen as C.E.O. *Paul Haitkin as Another Suit *Bobbin Bergstrom as Nurse Release Dates * USA - September 16, 2008 on Fox * Canada - September 16, 2008 on Global * Australia - September 24, 2008 on TEN * Portugal - November 10, 2008 on Fox * Latin America - November 13, 2008 on Universal Channel * Netherlands - January 8, 2009 on SBS 6 * Spain - January 6, 2009 on Cuatro * Germany - March 3, 2009 on RTL * Hungary - March 18, 2009 on TV2 * Denmark - March 21, 2009 on Kanal 4 * Mexico - May 5, 2009 * United Kingdom - May 31, 2009 on Sky One * Slovakia - September 2, 2009 on STV1 * Poland - September 3, 2009 on TVP2 * Belgium - September 5, 2009 * Czech Republic - September 7, 2009 on TV Nova * Sweden - September 29, 2009 on TV4 * Estonia - November 10, 2009 * Japan - July 13, 2010 In Other Languages * France & Quebec - Parle avec lui (Eng. Talk to him) * Latin America - La muerte lo cambia todo ''(Eng. Death Changes Everything) * Spain - ''Morir lo cambia todo ''(Eng. Dying Changes Everything) * Germany - Sterben verändert alles ''(Eng. Dying Changes Everything) Links *Episode page at IMDB *Episode article at Wikipedia *Episode review at Blogcritics *Quotes at House MD Quotes *Episode transcript at Clinic Duty *Episode page at House MD Guide *Episode guide at Ace Showbiz *Goofs at Movie Mistakes *Episode article at TV IV *Episode page at TV.com *Episode promo at The House of Fan *A review of the medicine at Polite Dissent *Illustrated episode quotes at Tumblr *Episode review at The Onon AV Club *Episode page at TV.com *Episode transcript at Springfield Springfield ''This article was the featured article for February, 2017 Category:Episodes Category:Season 5 Category:Featured articles